Driving pressure, a crucial concept in respiratory physiology and ventilator management, reflects the distending pressure applied to the lung during mechanical ventilation. It is determined by subtracting the positive end-expiratory pressure (PEEP) from the plateau pressure (Pplat). The result represents the pressure required to inflate the lung above the level of PEEP. For instance, if Pplat is 25 cm H2O and PEEP is 10 cm H2O, the driving pressure is 15 cm H2O.
Monitoring this value is essential for mitigating ventilator-induced lung injury (VILI). Elevated values can indicate excessive strain on the lung parenchyma, potentially leading to barotrauma or volutrauma. Maintaining it within a safe range, typically below 15 cm H2O, is often a primary goal in protective ventilation strategies. Historically, focus was primarily on tidal volume and peak inspiratory pressure. However, research demonstrated that this measure correlates more strongly with patient outcomes in acute respiratory distress syndrome (ARDS).
